About our research
Amongst other things, we have evaluated the effects of a person-centred approach in health care. Apart from the reduction of costs, significant positive effects from a patient perspective have been reported, as the care is tailored to each individual person, and his or her resources are considered and included.
Approximately 100 national and international researchers from different fields of study join forces to work on different studies at GPCC. These studies mainly revolve around person-centred care, rehabilitation, and elderly care in patient groups with different conditions, as well as organisation of care, and issues related to the implementation of person-centred care.
At GPCC, scientists from almost every faculty at the University of Gothenburg engage in interdisciplinary research. Experiences/symptoms of disease and ill health serve as a point of departure, and thus, a part of our research revolves around increasing understanding of the correlations between symptoms and organ dysfunctions, for example in cardiac and gastrointestinal disease. We also study how care and treatment can be improved through a person-centered approach, meaning that the patient’s narrative serves as a foundation for an agreement between the patient and health care professionals, regarding examinations and treatment. We also study how person-centred care can increase efficiency in health care. Furthermore, we work with the implementation of our results within health care.
GPCCs research can be sorted into four different domains:
- Theoretical and practical development of person-centred care
- Evaluation and measurement of person-centred care
- Implementation, organisation, leadership and governance of person-centred care
- Learning and education in person-centred care
Our research projects
Ongoing research projects
Completed research projects
A list of our completed research projects will be posted here during the autumn of 2020.
Phd projects and theses
Person-centred care has positive effects
GPCC has evaluated the effects of a person-centred approach in a number of studies in different health and care contexts, for example in othopaedic and internal medicine, as well as across the whole care continuum, from hospital care and outpatient care to primary care, and beyond. Apart from the reduction of costs, significant positive effects from a patient perspective have been reported, as the care is tailored to each individual person, and his or her resources are considered and included.
We have listed some examples below of findings emanating from researchers and projects linked to GPCC, as well as other researchers who have evaluated and described effects of the person-centred approach.
Shortened hospital stay, reduced costs, and higher care quality for patients with chronic heart failure
When persons suffering from chronic heart failure received person-centred care, their length of hospital stay was reduced by 30 percent, which resulted in a significant reduction of costs (Ekman et al 2012; Hansson et al, 2015).
Studies have also shown that the patient experience is improved, largely due to reduced uncertainty in relation to their illness and treatment (Dudas et al, 2013).
Improved quality of life in cancer treatment and palliative care
The person-centred approach in cancer and palliative care has been shown to improve quality of life, and reduce symptoms, when compared to a control group (Brännström & Boman 2014; Koinberg et al 2017).
Improved quality of life for mental health patients in primary care
Acupuncture combined with person-centred care was found to result in increased wellbeing and an improved feeling of coherence for persons with mental ill-health, when compared to traditional care. The patients reported less anxiety and depression, an increased mental wellbeing, as well as improved ability to handle stress, when compared to patients receiving traditional treatment.
At follow-up, approximately 50 percent of the patients stated that the method had led to reduced anxiety, from possible/probable to normal level, compared to 10 percent in those who had received standard care. The same pattern was evident for those suffering from depression (Arvidsdotter T, Marklund B, Taft C, 2013).
Reduced costs and improved quality of life for persons with hip fracture
One study examined the effects of person-centred care for patients with hip fractures. The number of hospital stay days were reduced by 50 percent. A significant reduction of pressure wounds and other medical complications was accomplished, and pain relief was improved. In addition, overall health care costs were reduced by 40 percent.
The same study shows that the greatest improvements were achieved amongst the oldest patients. In the group of 91-97 year-olds, the number of in-patient days were reduced from an average 46 to 12, compared to the age group 65-70, where the number of in-patient days were reduced from an average 16 to 14 (Olsson et al, 2009).
Positive effects for dementia patients and health care staff in dementia care homes
Following implementation of person-centred care at a dementia care home, a more welcoming atmosphere as well as reduced stress for staff was reported (Edvardsson D et al 2014).
Better results for acute coronary syndrome patients
Patients suffering from acute coronary syndrome, such as myocardial infarction, were found to have almost 2,7 times greater likelihood of improvement when they receive person-centred care, compared to traditional care. Primarily, the group who received person-centred care developed increased levels of self-efficacy compared to those in the control group. A personal health plan was created at the hospital, and then followed-up and discussed in primary care (Fors et al. 2015).
In a group comparison of patients with further education compared with those without, the latter group reported a greater improvement of their self-efficacy when a person-centered approach was used compared to the former group (Fors et al 2016).
Higher quality and reduced costs for chronic inflammatory arthritis, rheumatoid arthritis, and fibromyalgia patients
At a nurse clinic for persons suffering from chronic inflammatory arthritis, patient experiences were described as increasing security and participation. The cost comparative study showed that person-centred care resulted in more efficient use of resources, tailored to patients’ individual needs and resources. For example patients’ were more often referred to physiotherapists than to in-patient care, and fewer blood samples were taken (Larsson et al 2014).
Studies have shown reduced fatigue, increased muscle strength, improved self-efficacy and improved self-reported health in patients suffering from rheumatoid arthritis and fibromyalgia (Feldthusen C et al. Arch Phys Med Rehabil. 2015; Larsson A, et al. Arthritis Res Ther. 2015; 18;17:161).
Better use of health care resources
Health care resources should be used as efficiently as possible, and provide the best results achievable. By choosing person-centred care, it is possible to avoid over-prescription of medication, the provision of unwanted medical services, and conducting of surgery patients would rather do without (e.g Zang et al 2009).
The link between signs and symptoms
Through GPCC-based research we are gaining a better understanding of the connection between signs, i.e. what can be seen/measured by others, and symptoms, i.e. how we ourselves feel and experience our illness. For example, in Irritable Bowel Syndrome (IBS) there are signs, such as disrupted bowel function, which can be observed and measured in different ways by health care staff, but there are also symptoms, like bloating, which is what the patient experiences and can report on. Research is on-going in this area, with recent results displaying the difficulty in connecting these signs with symptoms.
Takotsubo syndrome (Broken heart syndrome) is an acute reversible heart failure, primarily afflicting postmenopausal women. The onset of the illness is similar to that of myocardial infarction, both in terms of symptoms and clinical signs. Studies have revealed severe symptoms, both before but also after the acute event which lead to hospital care (Wallström S et l 2015; 2016).
Remote person-centred care also works
Follow-up after hospital care of patients with COPD and/or heart failure demonstrated that those who received person-centred care via telephone in addition to usual care developed less worsening than those who received usual care only (Fors A et al 2018).
Alharbi TSJ, Ekman I, Olsson L-E, Dudas K, Carlström E. Organizational culture and the implementation of person-centered care: Results from a change process in Swedish hospital care. Health Policy. 2012 Dec;108(2-3):294-301.
Alharbi TS, Olsson LE, Ekman I, Carlström E. The impact of organizational culture on the outcome of hospital care: after the implementation of person-centred care. Scand J Public Health. 2014 Feb;42(1):104-10.
Arvidsdotter, T., Taft, C., Marklund, B., & Kylén, S. (2015). Quality of life, sense of coherence and experiences with three different treatments in patients with psychological distress in primary care: a mixed-methods study. BMC Complementary And Alternative Medicine, 15(1), 132-132.
Arvidsdotter T, Marklund B, Taft C. Effects of an integrative treatment, therapeutic acupuncture and conventional treatment in alleviating psychological distress in primary care patients - a prag¬matic randomized controlled trial. BMC Compl Alt Med. 2013 Nov 7;13(1):308.
Brannstrom M, Boman K. Effects of person-centred and integrated chronic heart failure and palliative home care. PREFER: a randomized controlled study. European journal of heart failure. 2014;16(10):1142-51.
Dudas, K., Olsson, L-E., Wolf, A., Swedberg, K., Taft, C., Schaufelberger, M., Ekman, I. Uncertainty in illness among patients withchronic heartfailure is less in person¬centred care than in usual care, European Journal of Cardiovascular Nursing, published online 9 January 2013.
Edvardsson D, Sandman PO, Borell L. Implementing national guidelines for person-centered care of people with demen¬tia in residential aged care: effects on perceived person-centeredness, staff strain, and stress of conscience. Int Psychogeriatr. 2014 Jul;26(7):1171-9.
Ekman, I., Hedman, H., Swedberg, K., & Wallengren, C. (2015). Commentary: Swedish initiative on person centred care. BMJ, 350, h160. 24.
Ekman, I., Swedberg, K., Taft, C., Lindseth, A., Norberg, A., Brink, E., et al. (2011). Person-centered care — Ready for prime time. European Journal of Cardiovascular Nursing, 10(4), 248-251.
Ekman, I., Wolf, A., Olsson, L. E., Taft, C., Dudas, K., Schaufelberger, M., et al. (2012). Effects of person-centred care in patients with chronic heart failure: the PCC-HF study. Eur Heart J, 33(9), 1112-1119.
Fors, A., Ekman, I., Taft, C., Björkelund, C., Frid, K., Larsson, M., et al. (2015). Person-centred care after acute coronary syndrome, from hospital to primary care - a randomised controlled trial. International Journal of Cardiology, 187, 693–699.
Fors A, Gyllensten H, Swedberg K, et al. Effectiveness of person-centred care after acute coronary syndrome in relation to educational level: Subgroup analysis of a two-armed randomised controlled trial. Int J Cardiol 2016;221:957-62.
Fors A, Blanck E, Ali L, Ekberg Jansson A, Fu M, Lindström Kjellberg I, et al. Effects of a person-centred telephone-support in patients with chronic obstructive pulmonary disease and/or chronic heart failure – a randomized controlled trial. Plos One 2018 [e-pubmed].
Hansson, E., Ekman, I., Swedberg, K., Wolf, A., Dudas, K., Ehlers, L., et al. (2015). Person-centred care for patients with chronic heart failure - a cost-utility analysis. Eur J Cardiovasc Nurs.
Hornsten, A., Lundman, B., Stenlund, H., & Sandstrom, H. (2005). Metabolic improvement after intervention focusing on personal understanding in type 2 diabetes Diabetes Res Clin Pract (Vol. 68, pp. 65-74). Ireland.
Hansson E, Carlström E, Olsson LE, Nyman J, Koinberg I. Can a person-centred-care intervention improve health-related quality of life in patients with head and neck cancer? A randomized, controlled study. BMC Nurs. 2017 Feb 21;16:9.
Larsson I, Fridlund B, Arvidsson B, Teleman A, Bergman S. Randomized controlled trial of a nurse-led rheumatology clinic for monitoring biological therapy. J Adv Nurs. 2014;70(1):164-75.
Larsson I, Bergman S, Fridlund B, Arvidsson B. Patients’ experiences of a nurse-led rheumatology clinic in Sweden: A qualitative study. Nurs Health Sci. 2012;14(4):501-7.
Olsson, L., Jakobsson Ung, E., Swedberg, K., & Ekman, I. (2013). Efficacy of person-centred care as an intervention in controlled trials - a systema¬tic review. Journal of Clinical Nursing, 22(3-4), 456-465.
Olsson, L. E., Hansson, E., Ekman, I., & Karlsson, J. (2009). A cost-effectiveness study of a patient-centred integrated care pathway J Adv Nurs (Vol. 65, pp. 1626-1635). England.
Olsson, L. E., Karlsson, J., & Ekman, I. (2007). Effects of nursing interventions within an integrated care pathway for patients with hip fracture J Adv Nurs (Vol. 58, pp. 116-125). England.
Ulin, K., Olsson, L.-E., Wolf, A., & Ekman, I. (2015). Person-centred care - An approach that improves the discharge process. European Journal Of Cardiovascular Nursing: Journal Of The Working Group On Cardio¬vascular Nursing Of The European Society Of Cardiology.
Wallström S, Ulin K, Määttä S, Omerovic E, Ekman I. Impact of long-term stress in Takotsubo syndrome: Experience of patients. Eur J Cardiovasc Nurs. 2015
Wallström S, Ulin K, Omerovic E, Ekman I. Symptoms in patients with takotsubo syndrome: a qualitative interview study. BMJ Open. 2016; 6:e011820.
Wallström S, Ulin K, Omerovic E, Ekman I. Self-reported symptoms 8 weeks after discharge: A comparison of takotsubo syndrome and myocardial infarction. Int J Cardiol. 224 (2016) 348-352.
Zhang B, Wright A.A, Huskamp H.A, Nilsson M.E, Maciejewski M.L, Earle C.C, Block S.D, Maciejewski P.K, Prigerson H.G . Health Care Costs in the Last Week of Life. Associations With End-of-Life Conversations. Arch Intern Med. 2009;169(5):480-488.